﻿@model KRM.Core.tblPersonal
@{
    ViewBag.Title = "Edit Personal Info";
}

<form action="/Profile/EditPersonalInfo" method="POST" class="form-horizontal" id="frProfilePersonalInfo">
    <input type="hidden" value="@Model.Id" name="Id"/>
    <div class="form-body">
        <h3 class="form-section" style="margin-top: -10px">Personal Info</h3>
        <div class="row">
            <div class="col-md-12" id="msg-frProfilePersonalInfo">
            </div>
        </div>
        <div class="row">
            <div class="col-md-6">
                <div class="form-group">
                    <label class="control-label col-md-3">Full Name<span class="required">*</span></label>
                    <div class="col-md-9">
                        <input type="text" name="FullName"class="form-control" required="required" value="@Model.FullName">
                    </div>
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label class="control-label col-md-3">Address<span class="required">*</span></label>
                    <div class="col-md-9">
                        <input type="text" name="Address"class="form-control" required="required"value="@Model.Address">
                    </div>
                </div>
            </div>
        </div>
        <div class="row">
            <div class="col-md-6">
             
                <div class="form-group">
                    <label class="control-label col-md-3">Mobile Phone</label>
                    <div class="col-md-9">
                        <input type="text" name="MobileTelephoneNumber"class="form-control"  value="@Model.MobileTelephoneNumber">
                    </div>
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label class="control-label col-md-3">Home Phone</label>
                    <div class="col-md-9">
                        <input type="text" name="HomeTelephoneNumber"class="form-control" value="@Model.HomeTelephoneNumber">
                    </div>
                </div>
            </div>
        </div>
        <div class="row">
            <div class="col-md-6">
                <div class="form-group">
                    <label class="control-label col-md-3">Email Address</label>
                    <div class="col-md-9">
                        <input type="text" name="EmailAddress"class="form-control"value="@Model.EmailAddress">
                    </div>
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label class="control-label col-md-3">Nationality</label>
                    <div class="col-md-9">
                        <input type="text" name="Nationality"class="form-control" value="@Model.Nationality">
                    </div>
                </div>
            </div></div>
        <div class="row">
            <div class="col-md-6">
                              
              
                <div class="form-group">
                    <label class="control-label col-md-3">Ethnicity</label>
                    <div class="col-md-9">
                        <input type="text" name="Ethnicity"class="form-control" value="@Model.Ethnicity">
                    </div>
                </div></div>
            <div class="col-md-6">
                <div class="form-group">
                    <label class="control-label col-md-3">National Insurance Number</label>
                    <div class="col-md-9">
                        <input type="text" name="NationalInsuranceNumber" class="form-control"value="@Model.NationalInsuranceNumber">
                    </div>
                </div>
            </div>

        </div>

        <div class="row">
            <div class="col-md-6">
                <div class="form-group">
                    <label class="control-label col-md-3">Gender</label>
                    <div class="col-md-9">
                        <select name ="Gender"class="form-control">
                            <option @(Model.Gender==true?"selected=selected":"") value="true">Male</option>
                            <option @(Model.Gender==false?"selected=selected":"") value="false">Female</option>
                        </select>
                    </div>
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label class="control-label col-md-3">Date Of Birth<span class="required">*</span></label>
                    <div class="col-md-9">
                        <div id =""class="input-group input-medium date date-picker" data-date="@DateTime.Now" data-date-format="mm/dd/yyyy" data-date-viewmode="years">
                            <input type="text" name="DateOfBirth" class="form-control"required="required"placeholder="mm/dd/yyyy" value="@Model.DateOfBirth.ToString("MM/dd/yyyy")" >
                            <span class="input-group-btn">
                                <button class="btn default" type="button"><i class="icon-calendar"></i></button>
                            </span>
                        </div>
                    </div>
                </div>
            </div>
        </div>
        <div class="row">
            <div class="col-md-6">
                <div class="form-group">
                    <label class="control-label col-md-3">Passport Number</label>
                    <div class="col-md-9">
                        <input type="text" name="PassportNumber" class="form-control" value="@Model.PassportNumber">
                    </div>
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label class="control-label col-md-3">Driving Licence Number</label>
                    <div class="col-md-9">
                        <input type="text" name="DrivingLicenceNumber" class="form-control" value="@Model.DrivingLicenceNumber">
                    </div>
                </div>   
            </div>       
        </div>
    </div>
    <div class="form-actions fluid">
        <div class="row">
            <div class="col-md-6">
                <div class="col-md-offset-3 col-md-9">
                    <button type="submit" class="btn btn green"><i class="icon-ok"></i>Save Changes</button>
                       <button type="reset" class="btn btn-default">Reset</button>                               
                </div>
            </div>
            <div class="col-md-6">
            </div>
        </div>
    </div>
</form>